You will need to sign on with your LLLID (La Leche League ID) before you can post. If you have never claimed your LLLID, create your LLLID now. To sign in, click the LLLID Sign On button in the upper right corner. Enter your LLLID Alias and click the button again.

Nursing after chemotherapy

This is my first post here. I've done some reading but haven't found advice specific to my situation. I'm attempting to cobble together a plan for the next couple weeks. Here's some background:

On 3/29 my son was born. Thayne is my first and only, and possibly my last. He nursed right away with no problems at all. I was comfortable even through the days my milk came in. Thayne regained to his birth weight of 8 lbs 12 oz within 5 days.
On 4/29 I was diagnosed with cancer. I'm still in damage control mode. There's so much to write about what's happened over the past 2 months. We had to stop nursing immediately. I had gone to the ER and learned that I needed surgery and chemo right away. I tried to nurse him as much as I could and called a nursing cousin to bring breastmilk for us. That started something amazing.

Thayne has been exclusively fed breastmilk by bottle since that night. The next morning we had a cooler of two weeks worth of milk donated by local moms. Then we got a shipment from Washington DC through my Ravelry friends. Then another month supply from local moms. Then a shipment from California, from Ravelry friends. A second shipment from DC. More coolers from local moms. We have enough to last Thayne through July.

Today is my last chemotherapy. My oncologist says we can nurse on 7/16. I have been pumping all along, attempting to keep my supply up. As the chemo has worn me down, more drugs have been introduced. I was pumping around 20 ounces consistently just 2 weeks ago, but now my supply is suffering. I pumped 5 times today and in this last session, got nothing out of my left breast and only an ounce from the right.

The chemo itself would only reduce my supply by about 5 ounces a day, and I was making it back up at first. Now I have to get a neulasta shot on 7/3, which will likely affect my supply. I've had neupogen after my last two chemo sessions, and it's brought my daily pumping total down to 5 ounces, twice. I haven't been supplementing because I'm not sure it's a good use of herbs right now. I have been renting a Medela Symphony from the hospital. At $100/month, not covered by insurance, it's not cheap. I do have a Pump in Style. My Symphony rental is up on 7/5. I was thinking to renew just because I'm used to it, it's easy, and I have enough going on that I don't want to change anything else this month.

Thayne takes about 30 ounces a day. He's very active during the day, and sleeps well at night. He will be 3 months and 2 weeks when we can nurse again. He hasn't nursed since he was 4 weeks old. He does root, and sucks on whatever body part comes near his mouth. We have kept him on newborn nipples and the Medela Calma nipple as much as possible. He will suck dents in unvented plastic bottles. I am very optimistic about his latch and strength.

We co-sleep and I spend a lot of time snuggling him in just my bra to get as much skin to skin time as we can. I'm actually a little worried about him latching on by accident in the middle of the night, so he spends a sleep shift or two in the pack in play right next to the bed some nights.

But back to the reasons I'm posting.

1) I need a plan for the next two weeks for getting my supply ready for nursey day on 7/16.
What pumping schedule should I have?
What supplements should I take?
What foods should I eat?

I was thinking to start taking the Lactation Blend I have twice a day starting today. I'll make some lactation cookies today too. Maybe I should start increasing my pumping sessions to every 3 hours during the day for the next few days. If I'm not back to 20+ ounces by the weekend I can power pump (10 minutes on, 10 minutes off for an hour).

2) I need a plan for bringing Thayne back to the breast that day.
How do I know whether to give him a bottle of milk?

Thankfully I'm off work for July, and potentially part of August. My mom is here through July to help as well. I've been fortunate in that regard as well.

I have read that I need to keep things casual and relaxed for Thayne. He's got too much awake time to really have a nursing vacation in bed all day, but I've made no plans that week. I'd like to basically spend that week attached together somehow. It's warmer here, so I was thinking we'd both be topless all day and just doing whatever he wants to do. Play time, feeding time, napping time, together all the time.

Re: Nursing after chemotherapy

Talk to your docs first about any herbs.
But to EP, which is basically what you are doing right now, a few things:

Hospital grade pump with correctly fitted horns
Pump for 120 minutes in every 24 hours broken into at least 8 sessions. 10 is better. 12 is even better, as that is how a newborn would be nursing, and that is the whole point....to imitate a baby as best you can.

So.....pump MORE. Nothing replaces frequent stimulation for milk production. I would start there myself. It is exhausting. I set alarms and pumped every 3 hours at night and then every 2 during the day. Night was midnight to 5am, just as it would be for a newborn. I was wiped out, as EPing is hard work. But...work on getting your guy to the breast. Try an SNS.

I know you dnt feel well though, or have energy, but when you feel better, that is how to do it

Re: Nursing after chemotherapy

A little progress. It would have been better if I'd gotten the last pumping session in. I'll try harder today.

Yesterday I also picked up a prescription for reglan to stilmulate milk production. I've taken one so far.

I also got an acupuncture treatment to focus on detoxing all the chemotherapy chemicals, and an ionizing footbath. The water was satisfyingly disgusting.

Feeling tired. My husband says I'm not eating enough, but there's only so much I can do in a day. He's helping by cooking and bringing me drink mixes with the glutamine and carbs I need. My neuropathy feels more tingly than it did before today. I hope that's a sign of more feeling coming back in my fingertips.

I talked to my husband about how milk production works and he's going to help me find the time to pump. He's also excited to set up meals for me so I'm eating healthier. Not that I eat crap, but he's a weightlifter and very opinionated on what I eat anyway. It will be nice to have his help.

It is NOT easy to get 8 pumping sessions in. I started taking Reglan on 7/5 and have been agitated and irritable since then. I don't think it's a good fit for me, so I stopped taking it today. I will keep on with the oatmeal, squash, and pumping as much as I can. Right now I'm feeling discouraged, but I think that's the Reglan too. Hopefully the effects will clear out tomorrow or the next day and my dopamine will go back to normal and I'll feel better.